Attorney-Approved Do Not Resuscitate Order Template for the State of North Carolina

What is a Do Not Resuscitate Order in North Carolina?

A Do Not Resuscitate Order (DNR) in North Carolina is a legal form that documents a person's wish not to have cardiopulmonary resuscitation (CPR) or advanced cardiac life support if their heart stops or if they stop breathing. This decision is typically part of a larger conversation about end-of-life care preferences and is documented by a healthcare provider in accordance with North Carolina law.

Who can request a DNR Order in North Carolina?

In North Carolina, a DNR order can be requested by:

• Any adult with the capacity to make their own healthcare decisions.
• A legally appointed healthcare power of attorney if the patient lacks decision-making capacity.
• The legal guardian of an individual who is unable to make healthcare decisions on their own behalf.

How can someone obtain a Do Not Resuscitate Order in North Carolina?

Obtaining a DNR in North Carolina involves a series of steps that usually begin with a conversation between the patient, their family, and their healthcare provider about end-of-life care preferences. Following this:

1. The healthcare provider must assess the patient’s condition and agree that a DNR is appropriate based on the individual’s health status and personal wishes.
2. A DNR order is then documented in writing by the healthcare provider and placed in the patient’s medical record.
3. The patient or their representative should also keep a copy of the DNR order readily available.

Does a DNR Order affect other types of medical treatment?

It's important to note that a DNR order specifically applies to CPR and does not prohibit other types of medical treatments or interventions. Patients with a DNR order can still receive medication, oxygen, and other forms of care aimed at providing comfort and addressing other health issues.

Can a Do Not Resuscitate Order be revoked or changed?

Yes, in North Carolina, a DNR order can be revoked or changed at any time by:

• The patient, if they are cognitively able to make their own healthcare decisions.
• The healthcare power of attorney or legal guardian, if the patient lacks decision-making capacity.

Is there a difference between a DNR and a living will in North Carolina?

Yes, there is a significant difference. A DNR order is a specific instruction not to perform CPR if a patient's breathing stops or if their heart stops beating. A living will, on the other hand, is a broader legal document that outlines a person’s preferences for a variety of medical treatments at the end of life or if they are unable to communicate their healthcare wishes. While a DNR focuses only on CPR, a living will can include instructions on the use of life-sustaining treatments, artificial hydration, and nutrition, among others.

How is a DNR Order recognized outside of a hospital setting in North Carolina?

In North Carolina, a DNR order is recognized outside of the hospital setting, such as in private homes, by emergency medical services (EMS). For EMS personnel to honor the DNR, it must be presented in a form that they recognize, often a DNR bracelet or the original paperwork. It's crucial for patients or their representatives to have the DNR order readily accessible in the event of an emergency to ensure their wishes are followed.

1. Not consulting with a healthcare provider: A DNR order needs to be discussed and signed by a licensed healthcare professional. Skipping this step might invalidate the entire document.

2. Failing to inform family members or caregivers about the DNR order: It is crucial that your loved ones know about your decision so they can ensure it is respected.

3. Not including specific personal information: Full name, date of birth, and other identifying information must be accurately filled out to ensure the DNR is correctly attributed to you.

4. Leaving the document unsigned or undated: Both your signature and that of the healthcare professional, along with the date, are necessary to make the DNR valid.

5. Misunderstanding the scope: Understanding what a DNR order does and does not cover is essential. It specifically relates to not performing CPR, but does not affect other treatments.

6. Not using the specific form for North Carolina: States have differing requirements and forms for DNR orders. Using a form that is not recognized by North Carolina can render it ineffective.

7. Failure to renew or update: Situations and decisions change. Regularly revisiting and updating your DNR order is important to ensure it reflects your current wishes.

8. Not making enough copies: You should keep the original and make several copies of the DNR order to give to your healthcare provider, hospital, family members, and anyone involved in your care.

9. Forgetting to review and compare with other advance directives: Ensure your DNR order is consistent with any other advance healthcare directives you may have, like a living will, to avoid any potential conflicts.

Maintaining accuracy, clarity, and making sure the correct procedures are followed when completing a DNR order can significantly impact its efficacy and your peace of mind. Understandably, you might find this topic sensitive and challenging, but taking it step by step and consulting with professionals can help guide you through the process.

Completing a North Carolina Do Not Resuscitate (DNR) Order form is a significant step for individuals who wish to have their preferences known about not receiving CPR (cardiopulmonary resuscitation) in the event their heart stops or they stop breathing. This DNR order is an important piece, but it often accompanies other legal and healthcare documents to ensure a person's full range of medical and end-of-life wishes are clearly documented and respected. Here are several other forms and documents commonly used alongside a DNR order in North Carolina.

• Advance Directive: This document allows individuals to outline their healthcare preferences, including decisions about life support, before they are unable to make these decisions themselves. It typically includes a living will and a healthcare power of attorney.
• Living Will: Specifically outlines what types of life-prolonging measures an individual wishes to refuse or accept. This can include treatments like mechanical ventilation or artificially administered nutrition and hydration.
• Healthcare Power of Attorney: A legal document that designates another person (a healthcare agent) to make healthcare decisions on behalf of an individual if they become incapacitated.
• Medical Orders for Scope of Treatment (MOST): A medical order form that specifies the types of life-sustaining treatments an individual wants or does not want. It is more comprehensive than a DNR and applies to various treatments, not just resuscitation.
• HIPAA Authorization Form: Allows healthcare providers to disclose an individual's health information to designated people, ensuring loved ones can obtain necessary information to make informed decisions.
• Organ and Tissue Donation Registration: Specifies an individual's wishes regarding organ and tissue donation and can be included in the state's registry or noted in other advance directive documents.
• Emergency Medical Information Form: Contains critical health information such as medical conditions, allergies, medications, and emergency contacts. It is helpful for emergency responders to make informed treatment decisions.
• Portable Medical Order Form: Similar to the MOST, it includes specific medical orders to be followed by healthcare providers, especially in emergency situations. This form travels with an individual across different care settings..

While a DNR order is crucial for expressing one's wishes regarding CPR, integrating it with other forms ensures a comprehensive approach to managing healthcare preferences. It's advisable for individuals to discuss these documents with a healthcare provider and a legal advisor to ensure their wishes are clearly documented and legally recognized in North Carolina.

The North Carolina Do Not Resuscitate (DNR) Order is quite similar to a Living Will, in that both documents guide medical teams on how to proceed in life-threatening situations. A Living Will specifies a person's wishes regarding medical treatment if they become unable to communicate those wishes due to illness or incapacity. Unlike a DNR, which strictly focuses on the non-initiation of CPR, a Living Will covers a broader scope of medical interventions and treatments.

Similarly, a Medical Power of Attorney (Healthcare Proxy) is another document that resembles the North Carolina DNR in its purpose of guiding healthcare decisions. It allows an individual to appoint a trusted person to make healthcare decisions on their behalf if they are unable to make those decisions themselves. While a DNR specifies one critical decision – the wish not to have resuscitation attempts – a Medical Power of Attorney covers any and all medical decisions, depending on the situation at hand.

An Advance Directive is a broader term that often encompasses elements of both Living Wills and Medical Powers of Attorney. It prepares for a time when an individual might be unable to make their own healthcare decisions. Because it includes instructions on the type of care an individual wants (or does not want), it shares similarities with a DNR. However, an Advance Directive's scope can be much broader, covering more than the refusal of CPR.

The POLST (Physician Orders for Life-Sustaining Treatment) form, like the DNR, is designed to ensure that a patient's wishes regarding end-of-life care are followed. It’s more comprehensive and actionable in medical settings as it travels with a patient across various care settings, dictating treatments that a patient does or does not want to receive beyond just CPR, effectively complementing a DNR order.

A Hospital Patient Directive is another document with similarities to a DNR. Used in hospital settings, it outlines a patient's preferences for medical treatment, including life-saving measures like resuscitation. While narrower in focus and possibly limited to the duration of a hospital stay, it serves a similar purpose in guiding healthcare providers on a patient's wishes concerning specific interventions.

Last but not least, the Five Wishes document, although broader and more holistic, shares a conceptual similarity with a DNR. It addresses personal, emotional, and spiritual needs in addition to medical wishes at the end of life, including a person's desire regarding resuscitation. By dealing with a wide range of care preferences, it encompasses the primary purpose of a DNR within a larger context of end-of-life planning.

Navigating the specific requirements of the North Carolina Do Not Resuscitate (DNR) Order form can be daunting. To ensure your intentions are clearly understood and legally respected, it is important to follow a curated set of guidelines. Below are lists of what you should and shouldn't do when filling out this crucial form.

Things You Should Do

1. Review the form closely with a healthcare provider. Their guidance ensures that you fully understand the implications of a DNR order and its effect on emergency medical care.
2. Ensure all required personal information is accurate and legible. Precise details are crucial for the form's validity and immediate recognition in emergency situations.
3. Discuss your decision with close family members or loved ones. Open conversation minimizes surprises and ensures that your wishes are clearly understood by those who matter most to you.
4. Securely store the original document and distribute copies to relevant parties. Healthcare providers, family members, and, in some cases, legal representatives should have access to this document.

Things You Shouldn’t Do

• Fill out the form without fully understanding the implications. A DNR order is a significant medical and legal document that demands comprehensive understanding before completion.
• Forget to update the form if your wishes change. Life circumstances and perspectives can evolve, necessitatinng a review and potential revision of the document to reflect your current desires.
• Fail to inform your primary healthcare provider of your DNR status. It is critical that those responsible for your care are aware of your wishes to ensure they are followed.
• Overlook the necessity for witness or notary signatures, where required. Some jurisdictions may demand these additional endorsements for the DNR order to be considered valid and enforceable.

Following these guidelines will help ensure that your health care preferences are respected and carried out in the manner you intend. Consult with healthcare professionals and legal advisors to make informed decisions about your DNR order.

Understanding the North Carolina Do Not Resuscitate (DNR) Order is crucial for ensuring that your healthcare wishes are respected. However, there are several misconceptions that can lead to confusion. Here, we aim to clarify some of these misunderstandings.

• Only the elderly can have a DNR Order: People often think DNR Orders are only for the elderly. However, a DNR Order can be appropriate for individuals of any age facing severe health conditions that prefer not to have CPR if their heart stops or if they stop breathing.

• A DNR Order means no treatment will be provided: Some believe that a DNR Order means medical staff will not provide any treatment. This is incorrect. A DNR Order only directs medical personnel not to perform CPR. Patients with a DNR Order will still receive all other appropriate treatments and care.

• Doctors decide to issue DNR Orders: There's a misconception that doctors unilaterally decide when to issue a DNR Order. In reality, DNR Orders are based on discussions between the patient (or their legally authorized representative) and their healthcare provider, respecting the patient’s wishes and health condition.

• A DNR Order is permanent: Many think once a DNR Order is in place, it cannot be changed. Patients can revoke or alter their DNR Order at any time based on their changing preferences or health status.

• Verbal DNR Orders are acceptable: In North Carolina, for a DNR Order to be legally recognized, it must be documented in writing, signed by a healthcare provider, and agreed upon by the patient or their representative. Verbal wishes alone do not constitute a valid DNR Order.

• All family members must agree for a DNR to be valid: While it’s beneficial for families to agree on a loved one’s care, a DNR Order legally only requires the consent of the patient (or their authorized representative) and their physician. Family disagreements do not invalidate a properly executed DNR Order.

• A DNR Order is effective in any setting: A common misconception is that a DNR Order is valid in all circumstances. The reality is that DNR Orders are primarily intended for use in healthcare facilities. Special forms or processes may be required for them to be recognized in non-clinical settings, such as at home.

• : Merely having a DNR symbol or notation on a driver’s license or ID is not sufficient in North Carolina. A formal, properly executed DNR Order must be presented to healthcare professionals for it to be obeyed.

Correcting these misconceptions can help ensure that individuals in North Carolina make informed decisions about their healthcare, particularly regarding CPR and life-saving interventions. It's important to communicate openly with healthcare providers and loved ones about your wishes.

Facing a situation that requires the contemplation of a Do Not Resuscitate (DNR) Order is never easy. In North Carolina, like in many other states, the DNR Order is a critical document for those wishing to declare their preference against resuscitative efforts should their heart or breathing stop. Here are five key takeaways about filling out and using the North Carolina Do Not Resuscitate Order form:

• Understand what a DNR is: A DNR Order is a legal document that directs medical personnel not to perform cardiopulmonary resuscitation (CPR) or other life-saving treatments if your heart stops or if you stop breathing. This is critical for individuals with terminal illnesses or those in severely compromised health who wish to natural progression toward death without aggressive interventions.
• It must be signed by a physician: In North Carolina, a DNR Order is not just a form you can fill out and expect to be honored. It requires a physician's signature to be valid. This means the decision to have a DNR in place should be discussed thoroughly with a healthcare provider who understands your health situation well.
• Discuss your wishes with loved ones: Before finalizing a DNR Order, it's important to have a conversation with family members or other loved ones about your wishes. These are the people who will be most affected by the order in an emergency situation, and having their understanding and support can ease the process significantly.
• Keep the DNR accessible: Once the DNR Order is signed and in place, it needs to be kept in a location where it can be easily found by emergency responders, such as on the refrigerator or in your wallet. In some cases, wearing a DNR bracelet is also recommended to ensure that the order is observed no matter where the event occurs.
• Review and update as necessary: Life circumstances and medical opinions can change over time. It's a good idea to review your DNR Order periodically with your healthcare provider to make sure it still reflects your current wishes. If changes are needed, a new form must be completed and signed by a physician.

Completing a DNR Order is a significant step that can greatly impact end-of-life care. It ensures that a patient's wishes are respected and can also provide peace of mind to the individual and their family. However, it's a decision that comes with much responsibility and requires careful consideration and consultation with healthcare professionals and loved ones.